The present disclosure is concerned with conditions and care of the shoulder and elbow which, whatever the primary method of treatment, may be managed post-operatively following a shoulder injury or non-operatively as part of a treatment plan, mainly by immobilization of the shoulder in a selected position, but where, in some cases or at some stages, an option for early mobilization of the forearm/elbow would be useful.
In most cases, users having shoulder surgery wear a sling post-operatively to stabilize the shoulder. Typically, surgeons recommend that the sling be worn at all times, even when the user is sleeping. Alternatively, slings also may be recommended by doctors as part of a non-operative shoulder/elbow treatment plan.
The traditional sling has a square or rectangular section of cloth that is folded to form a pocket for supporting a user's arm, thereby providing immobilization to the injured shoulder. The folded cloth is suspended from the user's neck and/or shoulders to retain the limb/arm in a fixed position. While the immobilization that the sling provides may result in some healing, it may also have a debilitating effect on the shoulder and/or elbow joints and muscles causing stiffness and loss of extension range. For example, in case of a shoulder sling, extended immobilization of the elbow may result in cubital tunnel syndrome. Some research indicates that in 10-20% of shoulder surgeries or non-operative treatments requiring shoulder slings, cubital tunnel syndrome will emerge and will require intensive physical therapy or additional surgery to cure it. Hence, when a user wears a shoulder sling, physicians often will instruct the user to periodically take the sling off, and flex and extend the elbow repeatedly to prevent cubital tunnel syndrome. However, there are several significant risks when the user takes the sling off, including injury to the user's shoulder (which itself may be in need of recovery) that is no longer supported by the sling.
Hence, it is desirable to devise a shoulder and arm orthosis that addresses the need to support the shoulder and arm and prevent cubital tunnel syndrome, yet provides a mechanism to securely and comfortably flex and extend the elbow without requiring the user to remove the supporting orthosis. This orthosis may desirably allow the user to easily disengage the forearm to flex and straighten out the elbow without requiring removal. It is further desirable to provide a shoulder and arm orthosis that allows for rehabilitative training of the user's arm and/or shoulder for physical therapy while allowing the user's arm and/or shoulder to remain supported by the orthosis. The shoulder and arm orthosis may also desirably provide support for portions of the arm, including the wrist/hand, when needed.